Spinal epidural abscess: the importance of early diagnosis and treatment

Objectives—To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess. Methods—A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience. Results—Imaging withMRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacua-tion combined with 6–12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus. Conclusion—Early diagnosis and appro-priate early antimicrobial chemotherapy with surgery is associated with an excel-lent prognosis